Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
Objectives Patients with inflammatory arthritis report that fatigue is challenging to manage. We developed a manualised, one-to-one, cognitive–behavioural intervention, delivered by rheumatology health professionals (RHPs). The Fatigue - Reducing its Effects through individualised support Episodes i...
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e054627.full |
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| author | Paul Ewings Emma Dures Sarah Hewlett Joanna Thorn Mwidimi Ndosi Siobhan Creanor Jo Adams Lance M McCracken Joe Lomax Susan Bridgewater Bryan Abbott Alice Berry Marie Urban |
| author_facet | Paul Ewings Emma Dures Sarah Hewlett Joanna Thorn Mwidimi Ndosi Siobhan Creanor Jo Adams Lance M McCracken Joe Lomax Susan Bridgewater Bryan Abbott Alice Berry Marie Urban |
| author_sort | Paul Ewings |
| collection | DOAJ |
| description | Objectives Patients with inflammatory arthritis report that fatigue is challenging to manage. We developed a manualised, one-to-one, cognitive–behavioural intervention, delivered by rheumatology health professionals (RHPs). The Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis (FREE-IA) study tested the feasibility of RHP training, intervention delivery and outcome collection ahead of a potential trial of clinical and cost-effectiveness.Methods In this single-arm feasibility study, eligible patients were ≥18 years, had a clinician-confirmed diagnosis of an inflammatory arthritis and scored ≥6/10 on the Bristol Rheumatoid Arthritis Fatigue (BRAF) Numerical Rating Scale (NRS) Fatigue Effect. Following training, RHPs delivered two to four sessions to participants. Baseline data were collected before the first session (T0) and outcomes at 6 weeks (T1) and 6 months (T2). The proposed primary outcome was fatigue impact (BRAF NRS Fatigue Effect). Secondary outcomes included fatigue severity and coping, disease impact and disability, and measures of therapeutic mechanism (self-efficacy and confidence to manage health).Results Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 (9.4%) and 27 (19.6%) missing primary and secondary outcome responses, respectively. Results indicated improvements in all measures except disability, at either T1 or T2, or both.Conclusions This study showed it was feasible to deliver the intervention, including training RHPs, and recruit and follow-up participants with high retention. While there was no control group, observed within-group improvements suggest potential promise of the intervention and support for a definitive trial to test effectiveness. |
| format | Article |
| id | doaj-art-d014f981d91344f19289365221c304e4 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-d014f981d91344f19289365221c304e42025-01-30T21:15:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-054627Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility studyPaul Ewings0Emma Dures1Sarah Hewlett2Joanna Thorn3Mwidimi Ndosi4Siobhan Creanor5Jo Adams6Lance M McCracken7Joe Lomax8Susan Bridgewater9Bryan Abbott10Alice Berry11Marie Urban12NIHR Research Design Service - South WestSchool of Health and Social Wellbeing, University of the West of England, Bristol, UKSchool of Health and Social Wellbeing, University of the West of England, Bristol, UK1 Bristol Trials Centre, University of Bristol, Bristol, UKSchool of Health and Social Wellbeing, University of the West of England, Bristol, UKExeter Clinical Trials Unit, University of Exeter, Exeter, UKHealth Sciences, University of Southampton, Southampton, UKDivision of Clinical Psychology, Uppsala University, Uppsala, SwedenFaculty of Health, University of Plymouth, Plymouth, UKSchool of Health and Social Wellbeing, University of the West of England, Bristol, UKAcademic Rheumatology, Bristol Royal Infirmary, Bristol, UKAcademic Rheumatology, Bristol Royal Infirmary, Bristol, UKDepartment of Rheumatology, Bristol Royal Infirmary, Bristol, UKObjectives Patients with inflammatory arthritis report that fatigue is challenging to manage. We developed a manualised, one-to-one, cognitive–behavioural intervention, delivered by rheumatology health professionals (RHPs). The Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis (FREE-IA) study tested the feasibility of RHP training, intervention delivery and outcome collection ahead of a potential trial of clinical and cost-effectiveness.Methods In this single-arm feasibility study, eligible patients were ≥18 years, had a clinician-confirmed diagnosis of an inflammatory arthritis and scored ≥6/10 on the Bristol Rheumatoid Arthritis Fatigue (BRAF) Numerical Rating Scale (NRS) Fatigue Effect. Following training, RHPs delivered two to four sessions to participants. Baseline data were collected before the first session (T0) and outcomes at 6 weeks (T1) and 6 months (T2). The proposed primary outcome was fatigue impact (BRAF NRS Fatigue Effect). Secondary outcomes included fatigue severity and coping, disease impact and disability, and measures of therapeutic mechanism (self-efficacy and confidence to manage health).Results Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 (9.4%) and 27 (19.6%) missing primary and secondary outcome responses, respectively. Results indicated improvements in all measures except disability, at either T1 or T2, or both.Conclusions This study showed it was feasible to deliver the intervention, including training RHPs, and recruit and follow-up participants with high retention. While there was no control group, observed within-group improvements suggest potential promise of the intervention and support for a definitive trial to test effectiveness.https://bmjopen.bmj.com/content/12/7/e054627.full |
| spellingShingle | Paul Ewings Emma Dures Sarah Hewlett Joanna Thorn Mwidimi Ndosi Siobhan Creanor Jo Adams Lance M McCracken Joe Lomax Susan Bridgewater Bryan Abbott Alice Berry Marie Urban Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study BMJ Open |
| title | Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study |
| title_full | Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study |
| title_fullStr | Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study |
| title_full_unstemmed | Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study |
| title_short | Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study |
| title_sort | brief intervention to reduce fatigue impact in patients with inflammatory arthritis design and outcomes of a single arm feasibility study |
| url | https://bmjopen.bmj.com/content/12/7/e054627.full |
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